Association of diabetes type and chronic diabetes complications with early exit from the labour force: register-based study of people with diabetes in Finland

Abstract Aims/hypothesis Diabetes and diabetes complications are a cause of substantial morbidity, resulting in early exits from the labour force and lost productivity. The aim of this study was to examine differences in early exits between people with type 1 and 2 diabetes and to assess the role of chronic diabetes complications on early exit. We also estimated the economic burden of lost productivity due to early exits. Methods People of working age (age 17–64) with diabetes in 1998–2011 in Finland were detected using national registers (Ntype 1 = 45,756, Ntype 2 = 299,931). For the open cohort, data on pensions and deaths, healthcare usage, medications and basic demographics were collected from the registers. The outcome of the study was early exit from the labour force defined as pension other than old age pension beginning before age 65, or death before age 65. We analysed the early exit outcome and its risk factors using the Kaplan–Meier method and extended Cox regression models. We fitted linear regression models to investigate the risk factors of lost working years and productivity costs among people with early exit. Results The difference in median age at early exit from the labour force between type 1 (54.0) and type 2 (58.3) diabetes groups was 4.3 years. The risk of early exit among people with type 1 diabetes increased faster after age 40 compared with people with type 2 diabetes. Each of the diabetes complications was associated with an increase in the hazard of early exit regardless of diabetes type compared with people without the complication, with eye-related complications as an exception. Diabetes complications partly but not completely explained the difference between diabetes types. The mean lost working years was 6.0 years greater in the type 1 diabetes group than in the type 2 diabetes group among people with early exit. Mean productivity costs of people with type 1 diabetes and early exit were found to be 1.4-fold greater compared with people with type 2 diabetes. The total productivity costs of incidences of early exits in the type 2 diabetes group were notably higher compared with the type 1 group during the time period (€14,400 million, €2800 million). Conclusions/interpretation We found a marked difference in the patterns of risk of early exit between people with type 1 and type 2 diabetes. The difference was largest close to statutory retirement age. On average, exits in the type 1 diabetes group occurred at an earlier age and resulted in higher mean lost working years and mean productivity costs. The potential of prevention, timely diagnosis and management of diabetes is substantial in terms of avoiding reductions in individual well-being and productivity. Graphical abstract

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Important Drop Rate of Acute Diabetes Complications in People With Type 1 or Type 2 Diabetes After Initiation of Flash Glucose Monitoring in France: The RELIEF Study

10.2337/figshare.14143874 ◽

2021 ◽

Author(s):

Ronan Roussel ◽

Jean-Pierre Riveline ◽

Eric Vicaut ◽

Gérard de Pouvourville ◽

Bruno Detournay ◽

...

Keyword(s):

Type 2 Diabetes ◽

Type 1 Diabetes ◽

Diabetes Complications ◽

Glucose Monitoring ◽

Flash Glucose Monitoring ◽

Freestyle Libre ◽

Before And After ◽

Acute Diabetes

Objective The RELIEF study assessed rates of hospitalization for acute diabetes complications in France, before and after initiating the FreeStyle Libre system. Research Design and Methods 74,011 patients with type 1 diabetes or type 2 diabetes who initiated the FreeStyle Libre system were identified from the French national claim database (SNDS) using ICD-10 codes, from hospitalizations with diabetes as a contributing diagnosis, or the prescription of insulin. Patients were sub-classified based on SMBG strip-acquisition prior to starting FreeStyle Libre. Hospitalizations for DKA, severe hypoglycemia, diabetes-related coma and hyperglycemia were recorded for the 12 months before and after initiation. Results Hospitalizations for acute diabetes complications fell in type 1 diabetes (-49.0%) and in type 2 diabetes (-39.4%) following FreeStyle Libre initiation. DKA fell in type 1 diabetes (-56.2%,) and in type 2 diabetes (-52.1%), as did diabetes-related comas in type 1 diabetes (-39.6%) and in type 2 diabetes (-31.9%). Hospitalizations for hypoglycemia and hyperglycemia decreased in type 2 diabetes (-10.8% and -26.5%, respectively). Before initiation, hospitalizations were most marked for people non-compliant with SMBG and for those with highest acquisition of SMBG, which fell by -54.0% and 51.2% respectively following FreeStyle Libre initiation. Persistence with FreeStyle Libre at 12 months was 98.1%. Conclusions This large retrospective study on hospitalizations for acute diabetes complication shows that a significantly lower incidence of admissions for DKA and for diabetes-related coma is associated with use of flash glucose monitoring. This study has significant implications for patient-centered diabetes care and potentially for long-term health economic outcomes.

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SUN-655 Helicobacter Pylori Infection Is Not Associated with Diabetes Among a Cohort of Diabetic Patients in Alexandria City, Egypt

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa046.276 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

Author(s):

Mohamed Fahmy Amara

Keyword(s):

Type 2 Diabetes ◽

Type 1 Diabetes ◽

Helicobacter Pylori ◽

Diabetic Retinopathy ◽

Diabetic Nephropathy ◽

Helicobacter Pylori Infection ◽

Diabetes Group ◽

Significant Difference

Abstract Abstract: Helicobacter Pylori infection is one of the most common bacterial infections in Egypt. A mounting body of evidence suggests the association of H Pylori infection with diabetes. H.Pylori is implicated in increasing insulin resistance and promoting chronic inflammation, resulting in the development of diabetes. This study aimed to estimate the prevalence of H.Pylori infection among a cohort of patients with diabetes in Alexandria city, Egypt and the possible role of this condition in the control of the glycemic profile. We also investigated the correlation between H.pylori infection and the presence of diabetes-related complications (diabetic nephropathy and retinopathy). The study was conducted on 300 subjects classified into three groups; Group (I): 100 patients with type 2 diabetes, Group (II): 100 subjects with type 1 diabetes, Group (III): 100 non-diabetic control subjects. Participants were subjected to detailed history taking and thorough clinical examination. Routine laboratory investigations were done, including HbA1c and fasting plasma glucose. Stool antigen test, on- site Helicobacter Pylori Ag Rapid Test-cassette was done. The mean duration of diabetes in type 2 diabetes was 8.18±5.87 years, while the mean duration in type 1 was 4.88± 3.02 years, which was statistically significante (p< 0.05). The results of the presented study showed that there was no significant difference in the prevalence of Helicobacter Pylori infection between type 1 and type 2 patients with diabetes (31% Vs 38%, p=0.298), moreover; after adjustment for age, there was no significant difference in the prevalence of Helicobacter Pylori infection among either group with diabetes (Group 1 and group 2) compared to the control group, (p= 0.756 and 0.066) respectively. There was no statistically significant association between the presence of Helicobacter Pylori infection in both type 1 and type 2 diabetes, and an elevated HbA1c level above 6.5%.(p= 0.772 and p=0.524) respectively. The prevalence of diabetic nephropathy in patients with type 2 and type 1 diabetes was 5% and 3% respectively, which was non-statistically significant (p=0.721). While the prevalence of diabetic retinopathy was 11% among patients with type 2 compared to 1% among patients with type 1 diabetes, which was statistically significant (p=0.003). There was no statistically significant correlation between Helicobacter Pylori infection and the presence of diabetic nephropathy or diabetic retinopathy. Helicobacter Pylori infection was not associated with diabetes and did not affect the HbA1c level. Helicobacter Pylori infection was not correlated to the presence of either diabetic nephropathy or diabetic retinopathy among both patients with type 2 and type 1 diabetes. Nothing to Disclose: MA, MM, AH No Sources of Research Support

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Management of diabetes complications in youth

Therapeutic Advances in Endocrinology and Metabolism ◽

10.1177/2042018819863226 ◽

2019 ◽

Vol 10 ◽

pp. 204201881986322 ◽

Cited By ~ 4

Author(s):

Lara E. Graves ◽

Kim C. Donaghue

Keyword(s):

Type 2 Diabetes ◽

Type 1 Diabetes ◽

Diabetes Complications ◽

Microvascular Complications ◽

Macrovascular Disease ◽

Macrovascular Complications ◽

Invasive Treatment ◽

Positive Effects

Type 1 and type 2 diabetes are increasing in prevalence and diabetes complications are common. Diabetes complications are rarely studied in youth, despite the potential onset in childhood. Microvascular complications of diabetes include retinopathy, diabetic kidney disease or nephropathy, and neuropathy that may be somatic or autonomic. Macrovascular disease is the leading cause of death in patients with type 1 diabetes. Strict glycaemic control will reduce microvascular and macrovascular complications; however, they may still manifest in youth. This article discusses the diagnosis and treatment of complications that arise from type 1 and type 2 diabetes mellitus in youth. Screening for complications is paramount as early intervention improves outcome. Screening should commence from 11 years of age depending on the duration of type 1 diabetes or at diagnosis for patients with type 2 diabetes. Diabetic retinopathy may require invasive treatment such as laser therapy or intravitreal antivascular endothelial growth factor therapy to prevent future blindness. Hypertension and albuminuria may herald diabetic nephropathy and require management with angiotensin converting enzyme (ACE) inhibition. In addition to hypertension, dyslipidaemia must be treated to reduce macrovascular complications. Interventional trials aimed at examining the treatment of diabetes complications in youth are few. Statins, ACE inhibitors and metformin have been successfully trialled in adolescents with type 1 diabetes with positive effects on lipid profile, microalbuminuria and measures of vascular health. Although relatively rare, complications do occur in youth and further research into effective treatment for diabetes complications, particularly therapeutics in children in addition to prevention strategies is required.

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Practical aspects of cardiovascular risk factors identify in patients with diabetes type 1 and 2

Clinical Practice ◽

10.17816/clinpract83803 ◽

2011 ◽

Vol 3 (1) ◽

pp. 4-9

Author(s):

Mehman N. Mamedov ◽

Marina N. Kovrigina ◽

Marina B. Buzurtanov

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Type 2 Diabetes ◽

Type 1 Diabetes ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Capillary Blood ◽

The Difference

The aim of this study was to investigate the characteristics of the risk factors and comparative analysis of different methods of identify of cardiovascular risk factors in outpatient with diabetes mellitus (DM) type 1 and 2. Methods. In cross-sectional clinical study included 244 persons with type 1 and type 2 mean age 46,4 yrs. All patients were interviewed using a questionnaire of WHO, they were measured blood pressure, heart rate, anthropometric data, including total fat mass with fat analyzer OMRON BF508. All patients were also measured venous and capillary blood glucose level, glycated hemoglobin (%), total cholesterol and triglycerides. Results. The difference between the two measurement glucose methods (in venous and capillary blood) was 6,7 0,6%. In patients with type 1 diabetes hypertension occurs 2.5 times in less compared with patients with type 2 diabetes. The difference between blood pressure measured by mechanical and automatic devices was less than 1%. The percentage of body fat, including visceral fat, both women and men with type 2 diabetes by age corresponds to the high deviation from the norm. Most men and women with type 1 and type 2 had hypercholesterolemia. Conclusion. Traditional cardiovascular risk factors are identified, not only among individuals with type 2 diabetes, but among patients with type 1 diabetes.

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Insulin gene VNTR, CTLA-4 +49A/G and HLA-DQB1 alleles distinguish latent autoimmune diabetes in adults from type 1 diabetes and from type 2 diabetes group

Tissue Antigens ◽

10.1111/j.1399-0039.2006.00745.x ◽

2007 ◽

Vol 69 (2) ◽

pp. 121-127 ◽

Cited By ~ 33

Author(s):

K. Haller ◽

K. Kisand ◽

H. Pisarev ◽

L. Salur ◽

T. Laisk ◽

...

Keyword(s):

Type 2 Diabetes ◽

Type 1 Diabetes ◽

Autoimmune Diabetes ◽

Insulin Gene ◽

Diabetes Group ◽

Latent Autoimmune Diabetes

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Important Drop Rate of Acute Diabetes Complications in People With Type 1 or Type 2 Diabetes After Initiation of Flash Glucose Monitoring in France: The RELIEF Study

10.2337/figshare.14143874.v1 ◽

2021 ◽

Author(s):

Ronan Roussel ◽

Jean-Pierre Riveline ◽

Eric Vicaut ◽

Gérard de Pouvourville ◽

Bruno Detournay ◽

...

Keyword(s):

Type 2 Diabetes ◽

Type 1 Diabetes ◽

Diabetes Complications ◽

Glucose Monitoring ◽

Flash Glucose Monitoring ◽

Freestyle Libre ◽

Before And After ◽

Acute Diabetes

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Humoral immune response to Covid-19 vaccination in diabetes: age-dependent but independent of type of diabetes and glycaemic control-the prospective COVAC-DM cohort study

10.1101/2021.11.05.21265849 ◽

2021 ◽

Author(s):

Caren Sourij ◽

Norbert Joachim Tripolt ◽

Faisal Aziz ◽

Felix Aberer ◽

Patrick Forstner ◽

...

Keyword(s):

Type 2 Diabetes ◽

Immune Response ◽

Type 1 Diabetes ◽

Cohort Study ◽

Glycaemic Control ◽

Healthy Controls ◽

Diabetes Group ◽

Antibody Levels

Aims: Immune response to COVID-19 vaccination and a potential impact of glycaemia on antibody levels in people with diabetes remains unclear. We investigated the seroconversion following first and second COVID-19 vaccination in people with type 1 and type 2 diabetes in relation to glycaemic control prior to vaccination and analysed the response in comparison to individuals without diabetes. Materials and Methods: This prospective, multicenter cohort study analysed people with type 1 and type 2 diabetes, well (HbA1c<7.5% or <58 mmol/mol) or insufficiently (HbA1c≥7.5% or ≥58 mmol/mol) controlled and healthy controls. Roche's Elecsys anti-SARS-CoV-2 S was used to quantify anti-spike protein antibodies 7-14 days after the first and 14-21 days after the second vaccination. Results: 86 healthy controls and 161 participants with diabetes were enrolled, 150 (75 with type 1 diabetes and 75 with type 2 diabetes) were eligible for the analysis. After the first vaccination, only 52.7% in the type 1 diabetes group and 48.0% in the type 2 diabetes group showed antibody levels above the cut-off for positivity. Antibody levels after the second vaccination were similar in people with type1, type 2 diabetes and healthy controls if adjusted for age, sex and multiple testing (p>0.05). Age (r=-0.45, p<0.001) and glomerular filtration rate (r=0.28, p=0.001) were significantly associated with antibody response. Conclusions: Anti-SARS-CoV-2 S antibody levels after the second vaccination were comparable in healthy controls, people with type 1 and type 2 diabetes, irrespective of glycaemic control. Age and renal function correlated significantly with the extent of antibody levels.

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